One-stop shopping for recovery? A systematic review of the evidence on U.S. recovery community centers.

Background: Increased recognition of the need for community-based substance use disorder (SUD) recovery support services (RSS) to complement and extend clinical care efforts has led to growth in a variety of RSS including recovery community centers (RCCs). Given increased national focus on expanding RCC research, this systematic review examined published research on RCCs.

Method: We searched five publicly available empirical databases to retrieve existing studies on the effects of RCC participation through May 2024. Standardized summarization and quality assessment tools were utilized to provide systematic reporting and ratings of study quality.

Results: Seven studies (participant Ns range = 78 to 3459) were included, none of which were randomized/non-randomized comparative effectiveness designs; four were single-group prospective/retrospective and three, cross-sectional. The longest follow-up duration was limited to 6-months. Participants were mostly white, male, with high clinical pathology, low socio-economic status, and low recovery capital; primary substance was inconsistently reported, but mostly opioids or alcohol. RCC participation duration and intensity were positively associated with improvements in substance use, recovery capital, and psychosocial functioning. Major limitations pertained to inadequate description of samples, no "intent-to-treat" analyses, lack of inferential analyses, and atheoretical delineations of tested models and variables.

Conclusions: Despite national growth of RCCs, the quantity and quality of existing evidence is limited. Where reported, participation appears to be correlated with reductions in substance use and improved well-being. The limited evidence suggests RCCs may serve as a distinct, visible community access point for individuals with high psychopathology and low recovery capital to access support and resources. Given the disparity between the observed growth and promising preliminary results of RCCs and lack of rigorous evaluation, this review highlights a compelling need for further research investment to provide better estimates of the potential clinical and public health utility of RCCs in the RSS landscape.